Tai Chi Resembles Drugs, Aerobics in Blood Pressure Lowering

Laird Harrison

June 01, 2016

BOSTON — Tai chi can lower blood pressure in older people as effectively as drugs or aerobic exercise, a new meta-analysis suggests.

The traditional Chinese discipline offers possibilities for older people who can't or don't want to exercise strenuously, said Linda Pescatello, PhD, from the University of Connecticut in Storrs.

"Tai chi is low intensity, it's social, and this modality would be very attractive to older adults," she told Medscape Medical News. This means that "they may be more adherent to it than to other forms of exercise."

And tai chi can provide other benefits, such as improved balance, she added.

Dr Pescatello and coauthor Yin Wu, MA, also from the University of Connecticut, presented the finding here at the American College of Sports Medicine 2016 Annual Meeting.

It comes on the heels of results from the SPRINT trial, recently reported by Medscape Medical News, which showed that people 75 years and older with hypertension benefit when target systolic blood pressure is 120 mm Hg, which is lower than current guidelines.

But antihypertensive drugs can cause adverse reactions and aerobic exercise can be difficult or uncomfortable, especially for people with comorbidities, such as osteoarthritis.

To understand how effective an alternative tai chi could be, the researchers looked at the medical literature and searched for ways to combine the effects of many small studies.

They found 28 studies of tai chi that measured blood pressure, and judged them to be of moderate quality. The studies consisted of 1296 people who did tai chi and 919 people who served in nonexercise control groups.

In the pooled cohort, average age was 62.1 years, average body mass index was 25.8 kg/m², average systolic blood pressure was 135.5 mm Hg, and average diastolic blood pressure was 80.5 mm Hg. Sixty-two percent of the people were women, 56% were Asian, and 39% were white.

On average, tai chi was performed for 61.1 minutes per session, 2.9 times a week, for 20.6 weeks.

Systolic and Diastolic Blood Pressure Lowering

During this time, the average drop in systolic blood pressure was 6 mm Hg and in diastolic blood pressure was 3 mm Hg. "Reductions are comparable to first-line antihypertensive medications," said Dr Pescatello. "They are consistent with what has typically been prescribed."

The researchers also identified some trends in the data. First, they found that the reduction in systolic blood pressure was greater in people who performed tai chi more frequently.

When tai chi was practiced more than three times a week, the average reduction in systolic pressure was 9.6 mm Hg, when it was practiced three times a week, the average reduction was 5.3 mm Hg, and when it was practiced fewer than three times a week, the average increase in systolic pressure was 1.1 mm Hg (P = .002).

For studies in which blood pressure was a primary outcome, the average reduction in systolic blood pressure was 9.1 mm Hg, whereas for those in which blood pressure was a secondary outcome, the average reduction was 1.3 mm Hg (P < .001).

When the researchers combined those two findings, they showed that when blood pressure was a primary outcome, the average reduction in systolic pressure in people who performed tai chi more than three times a week was 13.6 mm Hg.

Average reduction in diastolic pressure was greater in people with higher resting pressure than in those with lower resting pressure (4.0 vs 0.1 mm Hg). And reductions in diastolic pressure were greater in studies at higher risk for bias.

The researchers point out that all the studies in their analysis defined tai chi as a low-intensity physical activity with elements of attention to breathing and relaxation. But most said nothing about the intensity of the tai chi exercises, the type of breathing or relaxation techniques, and how blood pressure was measured, which could be a limitation of the meta-analysis.

Tai chi might reduce blood pressure through a variety of mechanisms. For example, Wu explained, it could reduce stress or improve autonomic control.

This study "goes to show you don't need to do crazy intense exercise to get cardiovascular benefits," said Sarah Herrick, PhD, from the Massachusetts College of Liberal Arts in North Adams.

During the same poster session, she presented a study that showed that yoga decreases anxiety and that heart rate varies during bouts of yoga.

Yoga, too, has shown the capacity to lower blood pressure, Wu pointed out.

Dr Pescatello, Mr Wu, and Dr Herrick have disclosed no relevant financial relationships.

American College of Sports Medicine (ACSM) 2016 Annual Meeting: Abstract 288. Presented June 1, 2016.


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